Important note: Information in this article was accurate in February 1999. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, February 8, 1999
Daniel J. DeNoon, Senior Editor
Soon after HIV infection, the virus and a person's immune system reach an equilibrium - called the viral setpoint - at which viral load remains virtually constant until just before disease progression. Exactly when this will happen is not known, but people with higher viral-load setpoints are at greater risk of rapid progression.
New data from the Multicenter AIDS Cohort Study (MACS) provides a clearer picture. The information comes from a MACS subcohort of men followed since seroconversion. Only 9.1 percent of these men received any anti-HIV drugs during the first three years of infection, and none received protease inhibitors during this time.
Men who rapidly developed AIDS had a more pronounced rate of increase in viral load over the first three years of infection, reported University of Pittsburgh researcher John Mellors in a presentation to the 6th Conference on Retroviruses and Opportunistic Infections, held January 31-February 4, 1999, in Chicago, Illinois.
"Progression to AIDS after seroconversion is strongly associated not only with the initial HIV-1 RNA level (setpoint) but also with its rate of increase over the first three years," wrote R. Lyles, Mellors, and colleagues in their presentation abstract.
"These historical control data will be of value for studies examining the impact of preventive vaccines on viremia and clinical outcomes after seroconversion.
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